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Association of Depression with Subclinical Coronary Atherosclerosis: a Systematic Review

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Abstract

To assess causal association of depression with subclinical coronary atherosclerosis, we performed computer-based and manual search of literature for studies which had assessed relationship of depression disorder with coronary atherosclerosis. All studies had diagnosed depression with validated tools in patients without diagnosed coronary artery disease. The Bradford Hill criteria of cause–effect association was consistently fulfilled by those studies which achieved statistical significance and further showed incremental strength of association with one or more of the following attributes: (1) prospective cohort study, met cause–effect criteria of “temporality”; (2) relatively severe and/or longer period of depression, met cause–effect criteria of “dose–response”; (3) depression with predominantly somatic symptoms cluster, met cause–effect criteria of “scientific plausibility”; (4) multiethnic larger sample, met cause–effect criteria of “population equivalence”; and (5) multicenter study, met criteria of “environmental equivalence.” Our results show that there is a significant association of depression with coronary atherosclerosis at its subclinical stages.

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Abbreviations

CVD:

Cardiovascular disease

CAD:

Coronary artery disease

CAC:

Coronary artery calcifications

SLE:

Systemic lupus erythematosus

BMI:

Basal metabolic index

GHQ:

General Health Questionnaire

CES-D:

Center for Epidemiologic Studies Depression Scale

PRIME-MD:

Primary Care Evaluation of Mental Disorders

MDI:

Major Depression Inventory

CARDIA:

Coronary Artery Risk Development in Adults

EISNER:

Early Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research Studies

MESA:

Multiethnic Study of Atherosclerosis

HEART:

Heart Effects on Atherosclerosis and Risk of Thrombosis

GHQ-30:

30-item General Health Questionnaire

PMBC:

Pittsburgh Mind-Body Centre

HSW:

Healthy Women Study

KEEPS:

Kronos Early Estrogen Prevention Study

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Authors and Affiliations

  1. College of Public Health, The University of Arizona, Tucson, AZ, USA

    Sher Ali Khan

  2. Department of Medicine, St. Joseph Hospital, Chicago, IL, USA

    Usman Shahzad

  3. Department of Medicine, West Virginia University, Morgan Town, WV, USA

    Muhammad Samsoor Zarak

  4. University of Aberdeen, Aberdeen, UK

    Junaid Channa

  5. Vanderbilt Spine Center and QOD-AANS, Vanderbilt University, Nashville, TN, USA

    Inamullah Khan

  6. Pediatric Cardiac Surgery, Vanderbilt University, Nashville, TN, USA

    Muhammad Owais Abdul Ghani

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  1. Sher Ali Khan
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Khan, S.A., Shahzad, U., Zarak, M.S. et al. Association of Depression with Subclinical Coronary Atherosclerosis: a Systematic Review. J. of Cardiovasc. Trans. Res. 14, 685–705 (2021). https://doi.org/10.1007/s12265-020-09985-4

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